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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 474 <br />PAID +S.'00� <br />Rec. No 22s ( 3 <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment / Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant ( t?ec Cloth/ sod " 3c ? 4 LJASr L' >2o9- 3—1 <br />(Name) (Address) (Phone) <br />Owner SRn,E <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />,4-6t i .J ,ar-t <br />CITY OF <br />ISLE CANADA <br />/C % ,10 i <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />Page 14 �{ <br />(SigJ r <br />WHITE— Office CANARY— Customer PINK —File GOLD — Planner JJ <br />cant) <br />(Date) <br />